“The Guts to Really Look at It”—Medicine and Race in Robert Colescott’s Emergency Room
This Arts and Medicine feature describes the use of the painting Emergency Room, by Robert Colescott, to broach uncomfortable discussions with emergency medicine trainees and faculty about organized medicine ’s contribution to racial injustice and inequity, past and present. (Source: JAMA)
Source: JAMA - January 12, 2021 Category: General Medicine Source Type: research

Broad, Durable Antibody Response in Universal Flu Vaccine Trial
An experimental flu vaccine regimen induced lasting antibodies against a range of influenza strains, according to the final results of a phase 1 trial. (Source: JAMA)
Source: JAMA - January 12, 2021 Category: General Medicine Source Type: research

Promising Strategies for Sickle Cell Disease and β-Thalassemia
Genetic approaches against sickle cell disease (SCD) and transfusion-dependent β-thalassemia (TDT) increased fetal hemoglobin and appeared to improve clinical outcomes in 2 small early trials, researchers reported in the New England Journal of Medicine. (Source: JAMA)
Source: JAMA - January 12, 2021 Category: General Medicine Source Type: research

Mixed Findings in Pediatric Neuroblastoma CAR-T Therapy Trial
An experimental chimeric antigen receptor T-cell (CAR-T) therapy was well tolerated without off-tumor effects in a trial involving children with relapsed or refractory neuroblastoma. Although the treatment did not achieve a prespecified clinical response, and some participants have since died, the research suggests a way forward for solid tumor CAR T-cell therapy, a major oncology goal. (Source: JAMA)
Source: JAMA - January 12, 2021 Category: General Medicine Source Type: research

Audio Highlights
Listen to the JAMA Editor ’s Audio Summary for an overview and discussion of the important articles appearing in this week’s issue of JAMA. (Source: JAMA)
Source: JAMA - January 12, 2021 Category: General Medicine Source Type: research

Postelection Prospects for Expanding Health Care Coverage
With the election of Joe Biden, the US will have a president who actively embraces the Affordable Care Act (ACA). During his campaign, Biden competed against progressive Democratic candidates who advocated for a Medicare-for-all plan, as well as an incumbent president who promoted less government involvement in health care. (Source: JAMA)
Source: JAMA - January 12, 2021 Category: General Medicine Source Type: research

The Prevention of Diabetes Mellitus
Elliott P. Joslin, M.D., Boston (Source: JAMA)
Source: JAMA - January 12, 2021 Category: General Medicine Source Type: research

Long-term Complications of Bariatric Surgery
To the Editor The review of benefits and risks of bariatric surgery by Dr Arterburn and colleagues emphasized the efficacy and safety of the procedure, as well as many of the long-term benefits. However, there are 2 additional risks often overlooked by practitioners: recurrent calcium oxalate urolithiasis and osteoporosis. Both risks appear to be more frequent after Roux-en-Y gastric bypass (RYGB), in which the principal site of calcium absorption, the duodenum, is bypassed. A marked increase in oxalate excretion after RYGB can be difficult to treat. Urinary calcium, on the other hand, is low, consistent with calcium malab...
Source: JAMA - January 12, 2021 Category: General Medicine Source Type: research

Postoperative Atrial Fibrillation After Noncardiac Surgery and Stroke
To the Editor Dr Siontis and colleagues reported that among patients undergoing noncardiac surgery, long-term risks of stroke or transient ischemic attack (TIA), subsequent atrial fibrillation (AF), and all-cause death were higher in patients with new-onset postoperative AF than in those without postoperative AF. The differences were maintained after adjustment for age and Charlson Comorbidity Index. However, factors selected for adjustment might bias their findings. (Source: JAMA)
Source: JAMA - January 12, 2021 Category: General Medicine Source Type: research

Postoperative Atrial Fibrillation After Noncardiac Surgery and Stroke —Reply
In Reply Dr Hu and colleagues argue that the CHA2DS2-VASc score rather than the Charlson Comorbidity Index should have been used for adjustment in the outcome comparisons between the groups with and without postoperative AF in our study. Conceptually, we selected the Charlson Comorbidity Index because it captures multimorbidity more comprehensively, as opposed to the CHA2DS2-VASc score, which incorporates only a few select variables. The effect of multimorbidity would be most important in a postoperative and elderly population such as the population in our cohort. It should also be noted that the CHA2DS2-VASc score was dev...
Source: JAMA - January 12, 2021 Category: General Medicine Source Type: research

Long-term Complications of Bariatric Surgery —Reply
In Reply Dr Weiss calls attention to 2 health conditions —nephrolithiasis and osteoporosis—after bariatric procedures, which we did not cover in our review. (Source: JAMA)
Source: JAMA - January 12, 2021 Category: General Medicine Source Type: research

Glaucoma —Topical Drug Summary
This Medical Letter review summarizes topical drug treatments for glaucoma by class, formulation, dosage, and cost. (Source: JAMA)
Source: JAMA - January 12, 2021 Category: General Medicine Source Type: research

Association of Fresh vs Cryopreserved-Thawed Embryo Transfers With Live Birth Rate After Assisted Reproduction
This cohort study uses US national registry data to compare the association of fresh vs cryopreserved-thawed embryo transfer and live birth rates among women undergoing assisted reproduction technology (ART) procedures using freshly retrieved donor oocytes between 2014 and 2017. (Source: JAMA)
Source: JAMA - January 12, 2021 Category: General Medicine Source Type: research

Effect of Out-of-Hospital Sodium Nitrite on Survival to Hospital Admission After Cardiac Arrest
This randomized trial compares the effects of paramedic-administered parenteral sodium nitrite (45 mg vs 60 mg) vs placebo on survival to hospital admission among adult patients with out-of-hospital pulseless collapse and cardiac arrest. (Source: JAMA)
Source: JAMA - January 12, 2021 Category: General Medicine Source Type: research

Neonatal Abstinence Syndrome and Maternal Opioid-Related Diagnoses in the US, 2010-2017
This study uses US national hospital database data to update estimates of prevalence of neonatal abstinence syndrome and maternal opioid-related diagnoses between 2010 and 2017, and to describe state-level variation and associated lengths of stay and costs. (Source: JAMA)
Source: JAMA - January 12, 2021 Category: General Medicine Source Type: research

Patient Information: Prolactinomas
This JAMA Patient Page describes the symptoms of prolactinomas, benign tumors of the pituitary gland, and explains how they are diagnosed and treated. (Source: JAMA)
Source: JAMA - January 12, 2021 Category: General Medicine Source Type: research

Partners and Pardners
In the pre-op room, my wife was given a scalene block for a brief procedure. She had shoulder surgery three months back, (Source: JAMA)
Source: JAMA - January 12, 2021 Category: General Medicine Source Type: research

Hummingbird Lessons —Limits and Beauty of End-of-Life Interventions
In this narrative medicine essay, a critical care and palliative care physician draws a valuable lesson about the limits and beauty of last-ditch interventions after failing to save a fledgling hummingbird chick in its nest. (Source: JAMA)
Source: JAMA - January 12, 2021 Category: General Medicine Source Type: research

Glaucoma in Adults —Screening, Diagnosis, and Management
This narrative review provides an update on the epidemiology, pathophysiology, screening, diagnosis, treatment, and prognosis of glaucoma. (Source: JAMA)
Source: JAMA - January 12, 2021 Category: General Medicine Source Type: research

Jama
(Source: JAMA)
Source: JAMA - January 12, 2021 Category: General Medicine Source Type: research

COVID-19 Precautions Hamper Breastfeeding Support
Nearly 1 in 5 hospitals reduced in-person lactation support and nearly three-quarters discharged new mothers in less than 48 hours to lessen the risk of contracting severe acute respiratory syndrome coronavirus 2, according to a CDC report. (Source: JAMA)
Source: JAMA - January 12, 2021 Category: General Medicine Source Type: research

Health Workers ’ Antibody Levels Wane After SARS-CoV-2 Infection
Antibodies to the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) decline during the weeks after infection, in some cases falling below the threshold for seropositivity within 2 months, according to a national study of health care workers. (Source: JAMA)
Source: JAMA - January 12, 2021 Category: General Medicine Source Type: research

Could Baking Soda Fight Leukemia Relapse After Stem Cell Transplant?
For patients with leukemia and other hematological malignancies, donor hematopoietic stem cells can recognize and attack remaining cancer cells after chemotherapy. But residual cancer cells ’ immune-suppressing effects can thwart these transplants and lead to eventual relapse, requiring a donor lymphocyte infusion. A new study suggests that a treatment as simple as sodium bicarbonate—better known as baking soda—can potentially boost donor lymphocytes’ ability to overcome relaps e after stem cell transplants. (Source: JAMA)
Source: JAMA - January 5, 2021 Category: General Medicine Source Type: research

Incorrect Data in Table and in Results Section
This article was corrected online. (Source: JAMA)
Source: JAMA - January 5, 2021 Category: General Medicine Source Type: research

Diversity in Medical Schools —Need for a New Bold Approach
In this issue of JAMA, Montgomery Rice details the wrenching history of Black men and women and medical education and the many challenges still thwarting the long-standing goal of increasing diversity in US medical schools. From her purview as dean at Morehouse School of Medicine, she offers unique insights and specifically illuminates the failure to increase the enrollment of Black medical students, especially at new medical schools, many of which have explicitly adopted diversity as a foundational pillar of contemporary mission statements. As a consequence, the medical schools serving historically Black colleges and univ...
Source: JAMA - January 5, 2021 Category: General Medicine Source Type: research

First Progeria Drug Is Approved
A new medication intended to reduce the risk of death from a genetic disease that causes premature aging has been approved for patients 1 year or older. (Source: JAMA)
Source: JAMA - January 5, 2021 Category: General Medicine Source Type: research

Antiviral Drug Approved for Postexposure Flu Prevention
The approved indication for baloxavir marboxil has been expanded to include postexposure influenza prevention for patients 12 years or older. (Source: JAMA)
Source: JAMA - January 5, 2021 Category: General Medicine Source Type: research

New Tool Offers Faster Notice of Foodborne Illness Outbreaks
The FDA has created a new way to inform the public about foodborne illness outbreaks before health advisories or product recalls are issued. (Source: JAMA)
Source: JAMA - January 5, 2021 Category: General Medicine Source Type: research

Management of Patients With a Patent Foramen Ovale With History of Stroke or TIA
This Clinical Guidelines Synopsis summarizes the American Academy of Neurology ’s practice advisory update on management of patients with a patent foramen ovale who have a history of stroke or transient ischemic attack. (Source: JAMA)
Source: JAMA - January 5, 2021 Category: General Medicine Source Type: research

Audio Highlights
Listen to the JAMA Editor ’s Audio Summary for an overview and discussion of the important articles appearing in this week’s issue of JAMA. (Source: JAMA)
Source: JAMA - January 5, 2021 Category: General Medicine Source Type: research

A 7-Point Action Agenda to End the COVID-19 Pandemic for President-elect Biden
President-elect Joseph Biden has a historic opportunity to reset the US response to coronavirus disease 2019 (COVID-19), but it is unrealistic to expect a sharp turnaround, given steep spikes in cases and deaths. Since the emergence of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in the US, the federal government has undermined science, conveyed confusing health messages, politicized public health agencies, and sowed distrust. Despite being ranked by the Global Health Security Index as first in pandemic preparedness before COVID-19, the US has been among the world ’s worst performers, with the most ca...
Source: JAMA - January 5, 2021 Category: General Medicine Source Type: research

Current Comment
(Source: JAMA)
Source: JAMA - January 5, 2021 Category: General Medicine Source Type: research

Postexercise Ankle-Brachial Index Testing to Diagnose Peripheral Artery Disease
To the Editor Dr Mehta and colleagues presented the advantages and drawbacks of postexercise ankle-brachial index (ABI) testing based on a clinical case. However, several concerns about the postexercise criteria were not mentioned in the article. Postexercise ABI criteria to diagnose peripheral artery disease (PAD) are debated. (Source: JAMA)
Source: JAMA - January 5, 2021 Category: General Medicine Source Type: research

Postexercise Ankle-Brachial Index Testing to Diagnose Peripheral Artery Disease —Reply
In Reply Dr Mah é and colleagues are concerned about the sensitivity and specificity of the thresholds used for diagnosing PAD in patients with normal (1.00-1.40) or borderline (0.91-0.99) resting ABI and exertional non–joint-related leg pain. The diagnostic threshold of either a postexercise ABI decrease of mor e than 20% or a postexercise ankle systolic pressure decrease of more than 30 mm Hg were suggested by Aboyans et al as a reasonable diagnostic criterion for PAD (recommendation class IIa; level of evidence A) in the 2012 American Heart Association scientific statement on measurement and interpretati on...
Source: JAMA - January 5, 2021 Category: General Medicine Source Type: research

Pulmonary Embolism Prevalence Among Patients With COPD With Acutely Worsening Respiratory Symptoms
This cross-sectional study characterizes the prevalence of pulmonary embolism defined by a uniform diagnostic algorithm in patients in France with COPD hospitalized with acutely worsening respiratory symptoms. (Source: JAMA)
Source: JAMA - January 5, 2021 Category: General Medicine Source Type: research

Patient Information: Bisphosphonates for Postmenopausal Osteoporosis
This JAMA Patient Page summarizes the benefits and possible harms of taking bisphosphonates for postmenopausal osteoporosis (age-related thinning of bones). (Source: JAMA)
Source: JAMA - January 5, 2021 Category: General Medicine Source Type: research

Sewing a Mask
The first effort is lopsided. Dark thread on light fabric shows every knotted stitch and wandering line. Thread bunches up at corners on the underside, the bobbin was pulled too tight, the settings wrong. (Source: JAMA)
Source: JAMA - January 5, 2021 Category: General Medicine Source Type: research

Highest Bidder —Creativity
In this narrative medicine essay, a physician explores a persistent memory of a high school peer who staked all on creativity as a value that physicians and future physicians ought to tap into to resolve today ’s strife as healers. (Source: JAMA)
Source: JAMA - January 5, 2021 Category: General Medicine Source Type: research

Management of Crohn Disease
This review discusses the diagnosis and management of Crohn disease, including the importance of disease severity and risk stratification when determining a treatment strategy, the importance of maintenance therapy, and the adverse effects of treatment options. (Source: JAMA)
Source: JAMA - January 5, 2021 Category: General Medicine Source Type: research

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(Source: JAMA)
Source: JAMA - January 5, 2021 Category: General Medicine Source Type: research

Diversity in Medical Schools —A Much-Needed New Beginning
This Viewpoint reviews the many factors contributing to underrepresentation of Black physicians in US medical training pipelines and the health care workforce, and urges actions to dismantle structural barriers to Black medical school enrollment and achieve racial parity in the profession. (Source: JAMA)
Source: JAMA - January 5, 2021 Category: General Medicine Source Type: research

Two Decades Since To Err Is Human
It has been more than 2 decades since the Institute of Medicine (IOM; now the National Academy of Medicine [NAM]) published To Err Is Human in 2000, which concluded that up to an estimated 98  000 deaths each year may result from preventable medical errors. In 2020, as a host of articles appeared to celebrate the anniversary of the report, the COVID-19 pandemic cruelly illustrated the ways in which the US health system has still fallen far short of the goal of providing safe, high-qual ity care. (Source: JAMA)
Source: JAMA - December 22, 2020 Category: General Medicine Source Type: research

Incorporating the Risk for Subsequent Primary Cancers Into the Care of Adult Cancer Survivors
A diagnosis of cancer is a feared and often unexpected event, affecting an estimated 1.8 million individuals annually in the US. Hereditary cancers are rare, accounting for approximately 10% of all incident cancers. The majority of adult-onset cancers are sporadic, increase with advancing age, and are associated with lifestyle behaviors, obesity, and infections that lead to acquired somatic mutations that eventuate in cancer, accounting for an estimated 50% to 60% of incident cancers. Cancer is often diagnosed early with screening tests, or when more advanced, is identified because of clinical symptoms or findings on physi...
Source: JAMA - December 22, 2020 Category: General Medicine Source Type: research

Digitalis Glycosides for Heart Rate Control in Atrial Fibrillation
Digitalis glycosides were first introduced into clinical use in 1785 by William Withering, a physician in Birmingham, England. A new study published in JAMA, also conducted by physicians in Birmingham, provides novel information on the use of digoxin for heart rate control in patients with atrial fibrillation (AF). (Source: JAMA)
Source: JAMA - December 22, 2020 Category: General Medicine Source Type: research

More Transparency Needed for COVID-19 Emergency Authorizations
To improve public trust, the US Food and Drug Administration (FDA) should be more transparent in publicly disclosing its reviews of safety and effectiveness data leading to Emergency Use Authorization (EUA) of coronavirus disease 2019 (COVID-19) vaccines and treatments, according to a recent report from the US Government Accountability Office (GAO). (Source: JAMA)
Source: JAMA - December 22, 2020 Category: General Medicine Source Type: research

Postpartum Depression Persists Longer Than Previously Thought
Postpartum depression might persist for up to 3 years after giving birth, according to a recent study conducted by researchers from the Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD). (Source: JAMA)
Source: JAMA - December 22, 2020 Category: General Medicine Source Type: research

Pharmacies Partner With HHS to Provide COVID-19 Vaccines
Chain and independent pharmacies have partnered with the federal government to maximize access to coronavirus disease 2019 vaccines at no cost when they ’re available, the US Department of Health and Human Services (HHS) recently announced. (Source: JAMA)
Source: JAMA - December 22, 2020 Category: General Medicine Source Type: research

Audio Highlights
Listen to the JAMA Editor ’s Audio Summary for an overview and discussion of the important articles appearing in this week’s issue of JAMA. (Source: JAMA)
Source: JAMA - December 22, 2020 Category: General Medicine Source Type: research

A British Tribute to the American Physician
In the London Lancet for October 20, page 507, an anonymous writer ventures a few reminiscent thoughts relative to the association of the British physicians with their American colleagues during the period of the war. It is a charming statement in which every medical reader should take pleasure. The statement follows: (Source: JAMA)
Source: JAMA - December 22, 2020 Category: General Medicine Source Type: research

Uptake and Accuracy of the ICD-10-CM Diagnosis Code for COVID-19 Among US Hospitalizations
This study uses administrative claims data to describe trends in use of ICD-10-CM diagnosis codes for novel coronavirus patients in January-May 2020, before and afer the April 1 release of the U07.1 code to facilitate billing for and case monitoring of COVID-19. (Source: JAMA)
Source: JAMA - December 22, 2020 Category: General Medicine Source Type: research